9 posts categorized "Vitamin D"

July 07, 2010

When my oldest son was 4, I tried giving him nutritional supplements to make up for his appalling diet. I mixed fish oil into his orange juice. I let him eat candy-like gummy multivitamins. And I stirred an expensive chocolate powder containing 31 fruit and vegetable extracts into his milk.

It eased my worries, but experts disagree on whether supplements do any good. Though some consider the products an effective insurance policy, other say they’re overhyped, can lead to an overdose and are only potentially useful if a child has a deficiency.

“An appropriate diet should cover all needs,” said Dr. Steven Daniels, a member of the American Academy of Pediatrics’ committee on nutrition. Parents of picky eaters may be concerned, he said, but the worry “is often misplaced because kids are growing and developing normally.”

Still, how many kids actually eat an ‘appropriate’ diet? Dr. Kathi Kemper, who chairs the holistic and integrative medicine department at the Wake Forest University School of Medicine often recommends a multivitamin or fish oil which contains omega-3 fatty acids because “people have a funny idea what a healthy diet actually is,” she said. Surveys show that 99 percent of American children do not meet the recommended daily allowance for one or more essential nutrients, Kemper said.

If you do use supplements, look for children’s brands. Avoid large doses of anything as some nutrients, such as iron and vitamin A, can become toxic. Also keep in mind that supplements are not standardized and quality is not well-regulated by the Food and Drug Administration.

Here’s a guide to some of the more common supplements:

Multivitamins: Multivitamins haven’t been shown to offer a tremendous benefit and aren’t recommended by the AAP, but they generally don’t hurt as long as they’re made for children and less than 100 percent of the daily recommended value. Gummy vitamins look and taste like candy; try brushing your child’s teeth afterward to avoid cavities, said registered dietitian, Judith Dodd, a food and nutrition advisor and spokeswoman for the International Food Information Council Foundation.

Fish oil/omega-3’s: Kemper recommends fish oil for children who don’t eat fish two or three times a week. Children who have specific issues, such as high triglcyerides--a type of fat in the blood which can raise the risk of heart disease--may need fish oil, said Daniels, but he doesn’t recommend it for the general population. In adults, omega-3 fatty acids found in fish oil have been linked to heart-health, but the scientific evidence backing brain benefits is inconclusive. The Federal Trade Commission has started cracking down on companies that make claims such as “promotes healthy brain function.” Omega-3’s are often given to children with attention deficit disorder or allergies, but again, evidence is limited.

Vitamin D: Studies have consistently shown that kids are not getting appropriate amounts of vitamin D in their diet, said the AAP’s Daniels. He added that it makes sense to take a multivitamin containing D. But scientists aren’t sure how much vitamin D children actually need. The AAP recommends 400 international units a day to prevent and treat rickets, a bone-softening disease. Dietary sources are limited but many foods, including milk and orange juice, are fortified with D. It’s also made by the body when the skin absorbs the sun’s rays.

Liquid or powdered fruit and vegetable extracts: Whole fruits and veggies are best. When choosing a supplement, much depends on how they are produced “because nutrients can be lost in the production process,” said registered dietitian Dee Sandquist, a spokeswoman for the American Dietetic Association. The biggest challenge, however, as I found out, could be getting your picky eater to consume the product in the first place.

Calcium: Children over age 3 are usually deficient in calcium: Only 15 percent of girls and 22 percent of boys meet the recommended intake levels, according to the federal dietary guidelines report. While a calcium supplement may be helpful, “milk has 9 vitamins and minerals which provide an array of health benefits which a calcium supplement will not,” said Sandquist, who also recommends nondairy options (soy, almond, rice) or getting calcium from other sources such as yogurt, cheese, cereal and orange juice. “I believe in the total diet,” she said. Like gummy vitamins, some calcium supplements resemble candy. But remember, it adds up. “We know about 500 mgs is the right amount for absorption,” Dodd said. “Anything beyond that, you’re simply excreting.”

Iron: The AAP recommends 5 to 10 mg of iron for breast-fed babies. But iron should only be supplemented if needed for a medical condition, such as anemia, said Sandquist.

May 24, 2010

Crystal Lake's Peggy Lim has a healthy respect for the sun's powerful ultraviolet rays, and on a recent shopping trip she agonized over choosing a sunscreen for her three children.

"I've always heard the higher the SPF (sun protection factor) the better, until you get to SPF 45," said Lim, who finally bought whatever happened to be in front of her. "Now my husband says the SPF doesn't matter as much as how much you use. What's the right amount? Do I have to apply it under their clothes? And how bad of a mother am I if I forget to reapply it?"

Like many people, Lim wants reliable sunscreen information to help sort fact from fiction. But although the U.S. Food and Drug Administration drafted guidelines three decades ago governing the safety, efficacy and labeling of sunscreen, official rules have yet to be implemented.

Critics of the agency say the lack of formal regulations has spawned misleading claims on products and put consumers at risk by encouraging them to rely too heavily on sunscreen for protection.

The FDA expects to finalize the rules in October; they would take effect by 2012.

In the meantime, to help consumers make decisions — and light a fire under the FDA — the Environmental Working Group on Monday released its annual Sunscreen Safety Guide, which rates sunscreens, lip balms and moisturizers, and features a database searchable by brand name. On Tuesday, Consumer Reports will issue its sunscreen guide.

The EWG, an advocacy group that has waged a four-year campaign promoting strict sun-safety standards, slammed the majority of the 1,400 products it tested. It recommends only 39 of 500 beach and sport sunscreens, primarily because of what it called "a surge in exaggerated SPF claims above 50" and concerns about ingredients in the products.

"Hats, clothing and shade are still the only completely reliable sun protection," said Jane Houlihan, EWG's vice president for research.

In fact, the long-delayed FDA rules would update labels to stress the importance of a comprehensive approach to sun protection that encourages seeking shade and covering up.

Sunscreen can help protect against sunburn, but contrary to what many people think, it hasn't yet been shown to prevent skin cancer or premature skin aging, according to the FDA.

Research has found that people who use sunscreen tend to stay in the sun longer than they might otherwise. That is particularly true if a product has a high SPF number, ratings the Environmental Working Group says "sell a false sense of security."

March 10, 2010

As I reported in "Vitamin D shows promise" the popular nutrient is being hailed as the answer to nearly every health issue under the sun. But despite the scientific attention being paid to vitamin D, experts caution that claims of wide-ranging health benefits are not yet supported by clinical evidence. Here's a quick look at some commonly asked questions:

Q: Who should have their vitamin D levels checked?

A: Research shows 3 of every 4 Americans don't get enough vitamin D. Breastfed infants, older adults, those with dark skin and people who are obese have a higher risk of deficiency, but there are no national guidelines on screening or dosing. Dr. Gregory Plotnikoff, an integrative physician and director of the Institute for Health and Healing in Minneapolis, recommends that all pregnant women, people with chronic illnesses and those seeking to minimize their risk of disease go to their doctor for a baseline blood test. Some medications can deplete vitamin D levels. You can get a self test through The Vitamin D Council, but it's best to partner with a doctor.

A: Vitamin D2 comes from mushrooms — as long as they've been dried in the sun and not in commercial ovens. The fungal cell walls contain ergosterol, which is converted to ergocalciferol, or D2, when exposed to the sun's ultraviolet rays. Vitamin D3, which is the same D3 our skin can produce with exposure to the sun, comes from sheep wool lanolin exposed to the sun's rays. Both are transformed into calcidiol and then to calcitriol. The jury is out on their relative potency, said Plotnikoff, though vitamin D3 may be more effective than D2.

Q: Which is a better source of vitamin D: the sun or supplements?

A: It depends whom you ask. The American Academy of Dermatology maintains that the harmful effects of sunlight outweigh the benefits of vitamin D production. The academy recommends food sources and supplements. The National Institutes of Health is on the fence. The agency said it's "prudent" to limit sun exposure, but also noted that some vitamin D researchers suggest getting 10 to 15 minutes of sun exposure twice a week — sans sunscreen — on the face, hands, arms or back. Those with darker skin need two to four times as much exposure for the same vitamin D production.

Q: Can I get vitamin D from a tanning bed?

A: You can — if you dare. Moderate use of commercial tanning beds that emit UVB radiation of 2 percent to 6 percent is effective for vitamin D synthesis. But there is a connection between indoor tanning and melanoma, the deadliest form of skin cancer, according to a study by the International Agency for Research on Cancer. THe IARC also classifies the UV exposure from tanning beds as "carcinogenic to humans."

Q: Does wearing sunscreen reduce the amount of vitamin D I get from the sun?

A: It can if it's sun protection factor 8 or higher, but most people apply it wrong or don't use enough to lead to a deficiency, according to the NIH. "Skin likely synthesizes vitamin D even when it is protected by sunscreen as typically applied."

As far as Dr. Joseph Mercola is concerned, vitamin D is the magic bullet we've all been looking for. A lack of this wonder nutrient, the controversial natural health advocate said, can set the stage for no fewer than 33 disorders, including autism, cancer, diabetes and infertility.

"Vitamin D appears to reduce your risk of dying from virtually ANY disease," he wrote on his popular Web site. His recommendation? Get more sun, relax in a tanning bed or try supplements such as "Sunshine Mist," a vitamin D spray he sells.

Long ignored and feared in high doses, vitamin D is being hailed as the answer to nearly every health issue under the sun. The excitement stems from a flurry of preliminary studies finding links between vitamin D deficiencies and various illnesses, and this summer the federal Institute of Medicine plans to announce revised recommendations regarding dietary intake of vitamin D and calcium that almost certainly will be higher.

Despite the scientific attention being paid to vitamin D, experts caution that claims of wide-ranging health benefits are not yet supported by clinical evidence.

Though D is thought to hold tremendous promise, we've been down this garden path before: Hopes for the powers of vitamin E, beta carotene, antioxidant vitamins, selenium and other nutrients collapsed under the weight of rigorous, randomized clinical trials.

"It's premature to go out and make a big deal out of vitamin D supplementation when we don't have the evidence," said endocrinologist Anastassios Pittas, co-director of the Diabetes Center at Tufts University Medical Center in Boston. "We've been burned before on nutrition-based interventions," he said.

Yet already, bread, pasta, orange juice and soy foods are being fortified with vitamin D, and sales of vitamin D supplements grew 116.5 percent, from $108 million to $234 million, from 2007 to 2008, according to Nutrition Business Journal estimates.

The body naturally makes the vitamin when the sun's ultraviolet rays hit the skin, but fear of health risks and modern lifestyles have limited sun exposure for many.

Mercola, a non-practicing osteopathic physician who owns a clinic in Hoffman Estates, is one of the nutrient's most public and ardent supporters, with an evangelical style that can grate on the nerves of more cautious physicians.

"I've been preaching about this for a long time," said Mercola, who started his campaign 10 years ago. "Eventually the evidence comes out."

Mercola said children should get almost six times the amount of vitamin D recommended by the American Academy of Pediatrics, while adults and pregnant women should be receiving 5,000 International Units, or IUs, per day.

Most leading vitamin D researchers recommend no more than 1,000 to 2,000 IUs a day, citing insufficient evidence for higher doses. The federal guidelines, which are widely considered to be woefully inadequate, range from 200 to 600 IUs, depending on age.

"Dr. Mercola popularizes and promotes vitamin D in a very passionate way," said Dr. Gregory Plotnikoff, a senior consultant at the Center for Healthcare Innovation in Minneapolis who is conducting vitamin D trials. Mercola's high dosing recommendations "may be correct, but we need supportive data," he said.

March 02, 2010

Vitamins shelved in the kitchen or the bathroom may lose their effectiveness, according to a Purdue researcher whose research has shown humidity can chemically change the product's composition.

Even if the lids are on tight, crystalline substances--including vitamin C, some forms of vitamin B and other dietary supplements--could start to deteriorate, said Lisa Mauer (at left), a Purdue associate professor of food science.

If there's moisture or ingredients dissolve, they'll have a shorter shelf live, lower quality and fewer available nutrients, Mauer said. In fact, within just a week, you can lose all the vitamin C in a product, depending on the conditions and formulation.

Simply opening and closing the package in a bathroom can add a little bit of humidity and moisture each time, Mauer said. "The humidity in your kitchen or bathroom can cycle up quite high, depending on how long of a shower you take, for example, and can get higher than 98 percent," Mauer said.

Brown spots (like the ones on the multivitamin I took last night) are another sign of nutrient degradation. Mauer suggested throwing these out, especially if they're children's vitamins. (I will.)

"They're not necessarily unsafe, but you're just giving them candy at that point with a high sugar content," she said.

On a related note, it's also a bad idea to keep pharmaceutical drugs in the bathroom, for some of the same reasons.

So where are you supposed to keep vitamins? If mine aren't in plain sight, I forget I have them.

The kitchen could work as long as the vitamins aren't near windows, the sink, dishwasher or stove. The key is steering clear of heat and humidity, said Mauer. Also, the freezer is better than the refrigerator but "beware of condensation after taking the products out of the freezer," she said.

March 23, 2009

Vitamin D—the so-called sunshine vitamin—is the wonder nutrient of the moment. While the vitamin is best known for helping build strong bones and absorb calcium, a deficiency can raise the risk of everything from immune disorders to colds and flu, according to recent research.

But testing for low levels of vitamin D may raise more questions than it answers. The tests aren't standardized, so the results can differ from one lab to another. Earlier this year, Quest Diagnostics recalled several thousand test results because of concerns about their accuracy.

Meanwhile, even if the tests are accurate, there's debate about how much vitamin D a person needs and whether supplements are worthwhile.

The body makes vitamin D when the sun's ultraviolet rays strike the skin, something that doesn't happen often in Chicago and other Northern cities in the winter. Lesser amounts are found in some foods—mainly fortified beverages—and dietary supplements.

The American Academy of Pediatrics recently doubled the amount of recommended daily vitamin D for children to 400 IUs per day, but some say the new guideline is still too low. The Vitamin D Council, for example, suggests giving children 2 years old and younger 1,000 IUs per day if they have little exposure to the sun's ultraviolet B rays.

Knowing your vitamin D level can be useful, said Gregory Plotnikoff, medical director of the Institute for Health and Healing in Minneapolis. He recommends a baseline measurement for those with recurrent or chronic illness, or for people with mysterious medical symptoms.

"Vitamin D is the single most cost-effective medical treatment in the U.S. today," said Plotnikoff, who tells his patients to get 1,000 IUs of vitamin D a day, well above the government guidelines of 200 to 600 IUs per day. "My recommendation is to check levels, replenish and maintain."

The most common way to have your vitamin D level tested is to see a doctor. But a new $65 at-home test is available through the Vitamin D Council, which has partnered with ZRT Laboratory. The test measures 25-hydroxyvitamin D or 25 (OH) D. Stick a finger or heel to get a few drops of blood and mail the kit back. The results will be mailed to you.

Plotnikoff urges going through a qualified doctor.

"I've always thought that self-diagnosis and self-treatment put one at risk for self-malpractice," he said.

May 24, 2007

It’s no wonder Chicagoans are less aware and less concerned about the dangers of the sun’s rays than those in other cities, according to a recent survey by the American Academy of Dermatology.

When we do see the sun, we’re told to stay out of it, especially at midday, or reapply sunscreen to prevent premature aging and skin cancer.

Yet sun exposure is perhaps the most important source of vitamin D, because ultraviolet rays (UV) trigger vitamin D synthesis in the skin. And sunscreens with a sun-protection factor (SPF) of 8 or greater will block the UV rays that produce vitamin D, according to the National Institutes of Health.

We called on some experts to help clarify the confusion over vitamin D, an underrated nutrient that studies have shown can prevent bone diseases, cancer, immune-system disorders and even the flu.

Q. Is sunshine the best way to get Vitamin D? A.Yes, but it’s also the most dangerous. The AAD says the harmful effects of sunlight outweigh the benefit of vitamin D production and recommends food sources and supplements.

If 17-year-old Niyesha Martin had known that breast-fed babies need vitamin D supplementation, her infant might have been spared near-fatal complications from rickets.

And if James Sipkins, an internist at Northwestern Memorial Hospital, had discovered the studies linking a vitamin D deficiency to immune-system disorders, he would have given his daughter supplemental doses in an effort to stave off Type 1 diabetes.

But vitamin D, the so-called “sunshine vitamin” because our body produces it when the sun warms our skin, flies largely under the radar. And some wonder whether we’ve set up an entire generation for a host of other health problems by demonizing the sun, encouraging the liberal use of sunscreen and setting daily vitamin D requirements too low.

Vitamin D, a hormone produced in response to ultraviolet radiation from sunlight, promotes calcium absorption to help form and maintain strong bones. Without it, bones become thin, brittle and misshapen.

But in the last decade, an avalanche of new research has suggested that it can help maintain a healthy immune system, ward off tuberculosis and prevent or reduce the risk of osteoporosis, muscle weakness, gum disease, diabetes, insulin resistance, arthritis, multiple sclerosis and more than a dozen types of cancer, including breast, colon and pancreatic.

And even though it’s free and the sun is finally shining in Chicago, most now agree we’re getting far too little of it.